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Ostomy Pouch, Urinary, One-Piece, Extended Wear

Massachusetts rates for HCPCS A4391

Ostomy pouch, urinary, with extended wear barrier attached (one piece), each

Rates data updated July 2026.

How much does Ostomy Pouch, Urinary, One-Piece, Extended Wear cost?

$8.71

Typical negotiated rate. In Massachusetts, July 2026.

Insurers have agreed to pay about $8.71 for this service. The price depends on where it is billed: about $8.71 from a physician practice, and about $6.76 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 9 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$8.71$4.79 to $8.71
FacilityA hospital or hospital-owned outpatient department$6.76$4.37 to $20.42

How much rates vary

Facilitymedian $7 · 10th to 90th $4 to $79Professionalmedian $9 · 10th to 90th $4 to $13
$10$100$1K$10Kfacility $7professional $9

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$4.37
Median
$4.37
Typical High
$4.37
Aetna
Setting
Professional
Modifier
Global
Typical Low
$4.37
Median
$5.25
Typical High
$13.80
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$9.33
Median
$9.55
Typical High
$79.43
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$3.80
Median
$8.13
Typical High
$12.02
BCBS
Setting
Facility
Modifier
Global
Typical Low
$6.76
Median
$6.76
Typical High
$20.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$5.37
Median
$5.89
Typical High
$6.76
Cigna
Setting
Professional
Modifier
Global
Typical Low
$5.01
Median
$5.01
Typical High
$7.08
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$60.26
Median
$3,630.78
Typical High
$9,772.37
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$8.71
Median
$8.71
Typical High
$12.88
Health New England
Setting
Professional
Modifier
Global
Typical Low
$5.13
Median
$5.13
Typical High
$5.13
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$9.33
Median
$9.55
Typical High
$79.43
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$3.80
Median
$8.13
Typical High
$12.02
United
Setting
Facility
Modifier
Global
Typical Low
$3.24
Median
$4.17
Typical High
$10.00
United
Setting
Professional
Modifier
Global
Typical Low
$3.89
Median
$7.76
Typical High
$8.71

Where Massachusetts sits

The same service costs 2.2 times more in Hawaii than in Colorado. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Massachusetts· 8th of 51

$8.71

HI $10.96CO $4.90

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.